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Master Thesis

Effet d’épargne morphinique peropératoire de la perfusion continue de lidocaïne intraveineuse en chirurgie bariatrique : une étude randomisée prospective

Abstract : Introduction: The aim of this study was the analysis of the intraoperative morphine sparing effect of intravenous lidocaine in bariatric surgery. Materials and method: This was an ancillary study of a monocentric, prospective, randomized, double-blind, placebo-controlled study in patients undergoing scheduled bariatric surgery. Inclusions took place between October 2017 and September 2018. Patients received a standard general anaesthetic and were randomized to intravenous lidocaine (1.5 mg/kg bolus prior to incision followed by a continuous infusion of 2 mg/kg/h reduced to 1mg/kg/h for one hour postoperatively) or equivalent volumes of 0.9% NaCl solution (bolus and continuous infusion). The primary endpoint was total intraoperative consumption of remifentanil. Two plasma dosages of lidocaine were performed in the study group. Results: 180 patients were included. There was no significant difference in total intraoperative remifentanil consumption between the two study groups. Intraoperative dosages of lidocaine showed an increase in the half-life of lidocaine. Doses calculated on the adjusted body weight did not exceed plasma toxicity thresholds. Conclusion: This study did not show an intraoperative morphine sparing effect of intravenous lidocaine. The infusion of lidocaine in this population with doses calculated on the adjusted body weight is safe. Further studies focusing on standardized morphine administration protocols and using intraoperative nociception monitoring are necessary in order to clarifiy the peroperative analgesic effect of lidocaine.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03287493
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Submitted on : Thursday, July 15, 2021 - 4:22:47 PM
Last modification on : Wednesday, August 25, 2021 - 3:25:32 AM

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  • HAL Id : dumas-03287493, version 1

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Claire Nicolle. Effet d’épargne morphinique peropératoire de la perfusion continue de lidocaïne intraveineuse en chirurgie bariatrique : une étude randomisée prospective. Médecine humaine et pathologie. 2020. ⟨dumas-03287493⟩

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